The Children'S Medical Group of Greenville, PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18728 Issued in MS

Legal business name

THE CHILDREN'S MEDICAL GROUP OF GREENVILLE, PLLC

Practice address

559 Arnold Ave Ste a
Greenville, MS 38701-5323

Phone

(662) 334-9915

Fax

(662) 334-9740

NPI assigned

Oct 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hosan Menanya Azomani, MDNPI 1457342388

Title

Manager

Phone

(662) 334-9915

Specialties & licenses 1

Addresses

Tax ID family

The Children'S Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Children'S Medical Group

  • Pediatrics Physician
  • Canton, MS
  • NPI 1629237656
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Children'S Medical Group

  • Pediatrics Physician
  • Canton, MS
  • NPI 1629237656
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hosan M Azomani, M.D

  • Pediatrics Physician
  • Greenville, MS
  • NPI 1457342388
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212278400000",
    "number": "1174711279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1735",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387021735",
            "telephone_number": "662-334-9915",
            "fax_number": "662-334-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 ARNOLD AVE STE A",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387015323",
            "telephone_number": "662-334-9915",
            "fax_number": "662-334-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDREN'S MEDICAL GROUP OF GREENVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2008-06-01",
        "status": "A",
        "authorized_official_last_name": "AZOMANI",
        "authorized_official_first_name": "HOSAN",
        "authorized_official_middle_name": "MENANYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-334-9915",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "18728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Greenville, MS
• Providers in Greenville, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.